胃绕道手术后吸烟与内有关:对一项随机临床试验数据的后期分析
Marlene F Bossen1, Johanne Gormsen2, Sara D Kristensen2
1Department of Gastrointestinal and Hepatic Diseases, Surgical Section, Herlev Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. marlene.fromm.bossen@regionh.dk.
Obesity surgery
|February 20, 2024
概括
吸烟显著增加了腹腔镜Roux-en-Y胃旁路术 (L-RYGB) 后内部的风险. 然而,吸烟并没有增加L-RYGB患者早期术后并发症的风险.
科学领域:
- 腹腔外科手术的结果
- 胃肠道手术并发症 胃肠道手术并发症
- 外科手术风险因素分析
背景情况:
- 内部是腹腔镜Roux-en-Y胃旁路术 (L-RYGB) 后的一个已知的并发症.
- 确定可修改的风险因素对于提高患者安全至关重要.
- 之前的研究并没有最终确定吸烟是L-RYGB后内部的独立风险因素.
研究的目的:
- 评估吸烟作为L-RYGB后内部的独立风险因素.
- 评估手术前吸烟状况与内发生率之间的关联.
- 为了确定吸烟是否会影响早期的术后并发症 (Clavien-Dindo等级≥2).
主要方法:
- 一个随机对照试验 (RCT) 的探索性后期分析,比较L-RYGB.中介膜缺陷关闭技术.
- 包括401名接受L-RYGB.患者.
- 主要结局:吸烟作为内部的危险因素的重要性;次要结局:早期的术后并发症.
主要成果:
- 手术前吸烟与更高的内部的风险显著相关 (HR 2.4, p=0.005),在调整后仍然存在 (HR 2.2, p=0.016).
- 11.0%的患者需要在5年内为内进行手术.
- 吸烟者与非吸烟者之间30天术后并发症没有显著差异 (p=0.657).
结论:
- 吸烟是L-RYGB.GB后发生内部的重要独立风险因素.
- 戒烟对于减少L-RYGB.后的长期并发症可能很重要.
- 吸烟似乎不会增加L-RYGB患者早期术后并发症的风险.
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